If a tree falls in a forest…

My Thoughts On A Potential CVS+ Aetna Deal

Some context….We’ve seen high levels of consolidation in the healthcare industry over the last 4- 5 years….a lot having to do with ACA and inter-industry competition. Yesterday, Amazon won regulatory approval to wholesale pharmaceuticals in 12 states. While it does seem Amazon will enter the pharma sales business, the larger elephant in the room, which I think CVS Health acknowledges with this move, is pharmaceutical benefits management (PBM). PBM has been a major driver of profits and growth for CVS and a key differentiator from the Walmarts of the world. Adding aetna will re-inforce their PBM business by giving them a larger network to play with and helps with diversification to weather an Amazon entrance into the pharmaceutical space. Amazon will start by selling pharmaceutical products but will eventually use Amazon Prime as a PBM which will ultimately drive down the cost of prescriptions for Amazon prime members while they take a cut of course. Interesting time to be a consumer.